Correlation Analysis Of Damp Heat Syndrome And Inflammation Index(CRP、ESR、FC) In Ulcerative Colitis And Observation Of Therapeutic Effect Of QingchangHuashi Decoction

Research 1 Correlation analysis of damp heat syndrome and inflammation index(CRP、ESR、FC)in ulcerativeObjective:To explore the correlation between the damp heat syndrome of ulcerative colitis and disease activity index and inflammation index(ESR,CRP,FC)by collecting and counting clinical cases,providing reference for clinical syndrome differentiation and treatment guidance.Method:A total of 112 patients with active ulcerative colitis were studied,including 72 cases in the damp heat syndrome group of large intestine and 40 cases in the damp accumulation syndrome group of spleen deficiency.The syndrome types of traditional Chinese medicine were all in line with the damp heat syndrome of large intestine.The symptoms of traditional Chinese medicine such as abdominal pain,diarrhea,mucopurulent bloody stool,urgency,anal burning,abdominal distention,short red urine and dry mouth pain were counted and quantified,According to the symptom score,the patients were divided into three groups:light,medium and heavy scores.According to the modified Mayo index table,the disease activity index(Mayo score)was calculated.The ESR,CRP and FC of stool were detected.To compare the difference of disease activity index and inflammation index between damp heat of large intestine group and damp accumulation of spleen deficiency group.The correlation between symptom score and disease activity index(Mayo score)and inflammation index(ESR,CRP,FC)was analyzed by Spearman correlation analysis.The ROC curve of working characteristics of subjects was drawn to analyze the value of each inflammation index(ESR,CRP,FC)in predicting TCM syndrome types,so as to guide clinical syndrome differentiation and treatment.Results:1.112 cases of ulcerative colitis were collected,including 57 cases of mild UC,43 cases of moderate UC,12 cases of moderate UC.They were divided into four groups according to the syndrome type of traditional Chinese medicine,including 40 cases of spleen deficiency and dampness accumulation syndrome,72 cases of large intestine dampness heat syndrome,32 cases of light group(0-20 points),25 cases of middle group(21-40 points),and 41-60 points of heavy group(41-60 points))There was no significant difference in gender and age distribution among all groups(P>0.05).2.The symptom score of large intestine damp heat syndrome in patients with severe UC was significantly higher than that in patients with moderate UC,and the difference was statistically significant(P<0.05).The ESR,CRP and FC levels of each group were significantly higher than those of the spleen deficiency and dampness accumulation group,the ESR,CRP and FC levels of the heavy group were higher than those of the middle group,and the ESR,CRP and FC levels of the middle group were higher than those of the light group The difference between groups was statistically significant(P<0.05).3.In 72 cases of UC with damp heat syndrome of large intestine,the score of damp heat syndrome of large intestine and Mayo score(r=0.905,P<0.05)ESR(r=0.844,P<0.05)CRP(r=0.63,P<0.05),FC(r＝0.896,P<0.05).There was a positive correlation between them,suggesting that the patients with damp heat syndrome of large intestine had obvious intestinal inflammatory reaction and disease activity.4.ROC curve shows that ESR level can distinguish UC patients with spleen deficiency and dampness accumulation syndrome from UC patients with large intestine dampness heat syndrome,and predict AUC of TCM syndrome type as 0.905(95%Cl is 0.851～0.959),when ESR serum defined value is 18.865mm/h,The sensitivity of ESR is 80.6%,the specificity is 92.5%.CRP level was used to distinguish UC patients with spleen deficiency and dampness accumulation syndrome and large intestine dampness heat syndrome,and to predict AUC of TCM syndrome type by 0.792.(95%CI is 0.703～0.88),when CRP serum defined value is 11.4mg/L,The sensitivity of CRP was 81.9%,the specificity is 90%.FC level was used to distinguish UC patients with spleen deficiency and dampness accumulation syndrome from UC patients with large intestine dampness heat syndrome,and to predict AUC of TCM syndrome type by 0.792,(95%Cl is 0.885-0.973),when ESR serum defined value is 463.2mm/h The sensitivity of ESR is 76.4%,the specificity is 82.5%Conclusion:The level of inflammation indexes(ESR,CRP,FC)in patients with ulcerative colitis and damp heat of large intestine syndrome was significantly higher than that in patients with spleen deficiency and damp accumulation syndrome.There is a positive correlation between the symptom score of large intestine damp heat syndrome and disease activity index(Mayo score)and inflammation index(ESR,CRP,FC).The definition values of ESR,CRP,FC are of certain value to distinguish the patients of spleen deficiency damp heat syndrome and UC of large intestine damp heat syndrome and to predict the syndrome type of traditional Chinese medicine.Research 2 Clinical effect of Qingchang Huashi Decoction on mild to moderate ulcerative colitis with damp heat syndrome of large intestineObjective:60 cases of ulcerative colitis in mild to moderate active stage were selected as the research object,The clinical efficacy and safety of qingchanghuashi Decoction in the treatment of active ulcerative colitis with damp heat syndrome of large intestine were evaluated,and the changes of inflammatory indexes(ESR,CRP,FC)were observed after treatment,so as to provide basis for clinical treatment of ulcerative colitis.Method:60 cases of active ulcerative colitis with damp heat syndrome of large intestine were divided randomly into two groups.The treatment group was treated with QingchangHuashi formula(200ml/time,twice/day)combined with mesalazine sustained-release granules(4g/day)orally,and the control group was treated with mesalazine sustained-release granules(4g/day).The total course of treatment was 12 weeks.Differences of clinical remission rate,clinical efficiency,endoscopic response rate,mucosal healing rate,TCM syndrome efficacy and TCM symptom score between the two groups were compared before and after treatment.The changes of ESR,CRP,FC levels after treatment were observed and the safety of medication was monitored.Results:Clinical efficacy:of the 30 cases in the treatment group,26 cases were clinically effective,with a total effective rate of 86.7%;of the 30 cases in the control group,18 cases were clinically effective,with a total effective rate of 60%.According to the test,P=0.02<0.05,indicating that the clinical efficacy of the treatment group was better than that of the control group.Clinical remission:in 30 cases of the treatment group,17 cases of clinical remission,with a remission rate of 56.7%;in 30 cases of the control group,9 cases of clinical remission,with a remission rate of 30%.According to the test,P=0.034<0.05,it shows that the remission of the treatment group is better than that of the control group.Endoscopic response:among the 30 patients in the treatment group,there were 16 patients who achieved the endoscopic response,with the endoscopic response rate of 53.3%;among the 30 patients in the control group,there were 7 patients who achieved the endoscopic response,with the endoscopic response rate of 23.3%.According to the test,P=0.016<0.05,indicating that the treatment group was superior to the control group in terms of the endoscopic response.Mucosal healing:in 30 cases of the treatment group,7 cases achieved mucosal healing,and the healing rate of intestinal mucosa was 23.3%;in 30 cases of the control group,6 cases achieved mucosal healing,and the healing rate of intestinal mucosa was 20%.According to the test,P=0.5>0.05,it showed that there was no difference in mucosal healing between the two groups.TCM syndrome efficacy:in the treatment group,there were 5 cases of clinical remission,14 cases of significant effect,8 cases of effective effect 3 cases of ineffective,and the total effective rate of TCM syndrome was 90%.In the control group,there were 2 cases of clinical remission,6 cases of significant effect,13 cases of effective,9 cases of ineffective,and the total effective rate of TCM syndrome was 70%.According to the test,P=0.005<0.01,indicating that the treatment group was significantly better than the control group in TCM syndrome efficacy Symptom score:before treatment,there was no difference between the two groups in the total score of TCM symptoms,the score of diarrhea,the score of purulent blood and stool,and the score of abdominal pain(P>0.05).After treatment,the symptom scores of the two groups were compared,and the two groups could better alleviate the clinical symptoms and the treatment group was better than the control group.After test,P<0.05,with statistical significance;inflammation index:before treatment,the ratio of ESR,CRP,FC of the two groups There was no difference(P>0.05).After treatment,ESR,CRP and FC of the two groups were compared.ESR,CRP and FC of the two groups could be reduced.The recurrence rate of ESR,CRP and FC of the treatment group(86.7%,90%,56.6%)was higher than that of the control group(73.3%,83.3%,36.6%).After test,P<0.05,which was statistically significant.Conclusion:Qingchanghuashi formula was superior to western medicine in promoting mucosal healing rate、reduce TCM syndrome score and reducing inflammation index.There is no adverse reaction.It is one of the treatment schemes for UC patients with mild and moderate colorectal damp heat syndrome,and it is worthy of clinical promotion and further study.